PMID- 21039815
OWN - NLM
STAT- MEDLINE
DCOM- 20110307
LR  - 20101102
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 27
IP  - 9
DP  - 2010 Oct
TI  - The contribution of intramyocardial hemorrhage to the "no-reflow phenomenon": a 
      study performed by cardiac magnetic resonance.
PG  - 1120-9
LID - 10.1111/j.1540-8175.2010.01213.x [doi]
AB  - BACKGROUND: Percutaneous coronary intervention (PCI) in acute myocardial 
      infarction (AMI) is sometimes complicated by microvascular damage and hemorrhage. 
      Hemoglobin degradation products have magnetic susceptibility effects which help 
      in detecting hemorrhagic AMI by T(2) -weighted cardiac magnetic resonance (CMR) 
      images. OBJECTIVES: To investigate the possibility to detect intramyocardial 
      hemorrhage after AMI and to assess its contribution to the delayed hypoenhanced 
      core on late gadolinium enhancement (LGE) CMR, a feature traditionally referred 
      to as microvascular obstruction. METHODS: Consecutive patients with AMI who 
      underwent PCI and CMR were investigated. Hypointense zones T(2) -weighted images 
      were labelled as "hemorrhagic" AMI. Areas of late hypoenhancement on LGE CMR were 
      considered as regions of persistent microvascular damage (PMD). Only transmural 
      AMI were considered. RESULTS: A total number of 108 transmural AMI patients were 
      eventually enrolled and divided into two groups according to the presence of 
      hypoenhancement on T(2) images. Thirty-two patients showed an hypointense stria 
      within the high signal intensity zone on T(2) -weighted images; all these patients 
      showed midmural PMD on LGE. Among the remaining 76 patients, only 14 (18.4%) 
      showed PMD in the subendocardial region. The angiographic outcome was worse in 
      patients with hemorrhagic AMI, with a lower prevalence of TIMI 3 (65.6% vs. 
      96.1%, P = 0.017) and higher prevalence of myocardial blush grade 0 (84.4% vs. 
      13.2%, P < 0.001) post-PCI. CONCLUSIONS: T(2) -weighted CMR in reperfused AMI 
      allows identification of hemorrhage, related to PMD areas on LGE images and to a 
      worse reperfusion profile on angiography. These features open new avenues of 
      investigation for prognostic assessment of reperfused AMI.
CI  - (c) 2010, Wiley Periodicals, Inc.
FAU - Marra, Martina Perazzolo
AU  - Marra MP
AD  - Division of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, 
      University of Padua, Padua, Italy. martina.perazzolomarra.1@unipd.it
FAU - Cacciavillani, Luisa
AU  - Cacciavillani L
FAU - Corbetti, Francesco
AU  - Corbetti F
FAU - Tarantini, Giuseppe
AU  - Tarantini G
FAU - Ramondo, Angelo Bruno
AU  - Ramondo AB
FAU - Napodano, Massimo
AU  - Napodano M
FAU - Basso, Cristina
AU  - Basso C
FAU - Lacognata, Carmelo
AU  - Lacognata C
FAU - Marzari, Armando
AU  - Marzari A
FAU - Maddalena, Francesco
AU  - Maddalena F
FAU - Iliceto, Sabino
AU  - Iliceto S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
SB  - IM
MH  - Female
MH  - Hemorrhage/*diagnosis/*etiology
MH  - Humans
MH  - Magnetic Resonance Angiography/*methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - No-Reflow Phenomenon/*complications/*diagnosis
EDAT- 2010/11/03 06:00
MHDA- 2011/03/08 06:00
CRDT- 2010/11/03 06:00
PHST- 2010/11/03 06:00 [entrez]
PHST- 2010/11/03 06:00 [pubmed]
PHST- 2011/03/08 06:00 [medline]
AID - 10.1111/j.1540-8175.2010.01213.x [doi]
PST - ppublish
SO  - Echocardiography. 2010 Oct;27(9):1120-9. doi: 10.1111/j.1540-8175.2010.01213.x.